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Effect of norepinephrine on ketogenesis, fatty acid oxidation, and esterification in isolated rat hepatocytes.

Recent studies in man demonstrated a marked ketogenic effect of increased plasma norepinephrine concentrations as observed in diabetic ketoacidosis. Since this effect may have been due either to increased substrate supply for ketogenesis (lipolysis) or to direct hepatic activation of ketogenesis, the latter mechanism was examined in isolated rat hepatocytes. Incubation of hepatocytes with norepinephrine (10(-7) to 10(-4) M) resulted in a dose-dependent increase in conversion of the long-chain fatty acid [1-14C]palmitate into ketone bodies and CO2. Norepinephrine decreased [1-14C]palmitate conversion into triglycerides without affecting fatty acid uptake. Norepinephrine enhanced ketogenesis from [1-14C]palmitate in a physiologic range of fatty acid concentrations (0.5-2.5 mM), but failed to affect fatty acid esterification to phospholipids or mono- and diglycerides. In contrast to long-chain fatty acids, oxidation of the medium-chain fatty acid [1-14C]octanoate to ketone bodies was not enhanced by norepinephrine, whereas CO2 production increased. The effect of norepinephrine on [1-14C]fatty acid oxidation was blocked by the alpha 1 receptor blocker prazosin. The results demonstrate that norepinephrine diverts long-chain fatty acids into the pathways of oxidation and ketogenesis away from esterification, suggesting enhanced carnitine-dependent mitochondrial fatty acid uptake. The studies using octanoate indicated that norepinephrine also enhanced fatty acid oxidation by increasing the flux of acetyl-CoA through the Krebs cycle. The data suggest that stress-associated sympathetic activation and norepinephrine discharge, as observed in diabetic ketoacidosis, result in direct activation of ketogenesis in the liver.

Adrenergic alpha-Antagonists↗

Inhibition of lipase activity and lipolysis in rat islets reduces insulin secretion.

Lipids may serve as coupling factors in K(ATP)-independent glucose sensing in beta-cells. We have previously demonstrated that beta-cells harbor lipase activities, one of which is the hormone-sensitive lipase. Whether beta-cell lipases are critical for glucose-stimulated insulin secretion (GSIS) by providing lipid-derived signals from endogenous lipids is unknown. Therefore, using a lipase inhibitor (orlistat), we examined whether lipase inhibition reduces insulin secretion. Islet lipolysis stimulated by glucose and diglyceride lipase activity was abolished by orlistat. Incubation of rat islets with orlistat dose dependently inhibited GSIS; this inhibition was reversed by 1 mmol/l palmitate, suggesting that orlistat acts via impaired formation of an acylglyceride-derived coupling signal. Orlistat inhibited the potentiating effect of forskolin on GSIS, an effect proposed to be due to activation of a lipase. In perifused islets, orlistat attenuated mainly the second phase of insulin secretion. Because the rise in islet ATP/ADP levels in response to glucose and oxidation of the sugar were unaffected by orlistat whereas the second phase of insulin secretion was reduced, it seems likely that a lipid coupling factor involved in K(ATP)-independent glucose sensing has been perturbed. Thus, beta-cell lipase activity is involved in GSIS, emphasizing the important role of beta-cell lipid metabolism for insulin secretion.

Adipocytes↗

Studies in cholestasis of pregnancy. III. Fatty acid composition of serum phosphoglycerides.

The influence of cholestasis of pregnancy (CP) on liver lipid synthesis as reflected by the composition of serum phosphoglycerides was studied in 28 pregnant women in the last trimester by means of gas-liquid-chromatography (GLC). All patients complained of pruritus and had immunologically detectable lipoprotein-X (LP-X) in serum. Twenty women with uncomplicated pregnancies served as a control series. In lecithin, low palmitic acid (16:0) and high oleic acid (18:1 (n-9)) were found which appear to be characteristic for CP. The increased oleic acid suggests an enhanced liver lecithin synthesis through the cytidine-diphosphate diglyceride pathway. Measurement of the concentrations of lecithin from the gas-liquid-chromatograms was made possible by the use of an internal standard fatty acid added, which gave a linear relation to direct determination of lecithin. For further studies of influences of cholestasis of pregnancy on the relative fatty acid composition, lecithin was chosen because differences between lecithin (PC) and phosphoglycerides (GPL) were found, evidently due to mutual variations among the three components in GPL (lecithin, cephalin and lysolecithin).

Cholestasis↗

Studies in cholestasis of pregnancy. VI. Fatty acid composition of glycero-phospholipids before and after delivery.

Eight pregnant women, complaining of generalized pruritus with lipoprotein-X (LP-X) in their serum and diagnosed as cases of cholestasis of pregnancy (CP)--were studied during pregnancy and after delivery. Ten women with uncomplicated normal pregnancy served as controls. LP-X, liver function tests and relative fatty acid composition of serum lecithin (determined by gas-liquid chromatography, GLC) were followed. The fatty acid composition in liver and serum lecithin is determined by the synthesis pathways of lecithin in the liver. The faster and quantitatively dominating cytidine-diphosphate diglyceride pathway, pathway I, causes the appearance of lecithin with palmitic acid (16:0) in 1-position and oleic (18:1) or linoleic (18:2) acid in 2-position, while pathway II, with methylation of phosphatidyl-ethanolamine (cephalin) preferentially cases the appearance of lecithin with stearic acid (18:0) in 1-position and arachidonic acid (20:4) in 2-position. Pathway I is enchanced by oestrogenic and pathway II by cholestatic influence. During pregnancy women with CP were characterized in their serum lecithin fatty acid composition by a high palmitic (16:0) and a high oleic (18:1) acid content, in agreement with earlier studies. After delivery, in women with prior CP a decrease in palmitic (16:0) and linoleic (18:2) acids and an increase in stearic (18:0) acid, was interpreted as decreased influence on the major lecithin synthesis pathway I and an enhancement of pathway II. In addition, after delivery in the lactating mother, serum lecithin fatty acid composition data revealed an essential fatty acid (EFA) "consumption." It was earlier shown, that women with previous CP (when studied 8--21 months after delivery) had as judged from their serum lecithin fatty acid composition, a "basic metabolic defect," expressing presumably as estrogen enhanced pathway II of liver lecithin synthesis. In the present study, soon after delivery (on day 4--8) women with prior CP showed, however, less pathway II influence than women with a prior normal pregnancy. This was interpreted as a presistence of the cholestatic influence on liver lecithin synthesis pathways at this short time after delivery. Serum lecithin fatty acid composition appears to be a sensitive variable for the evaluation of metabolic influences in the liver.

Adult↗

Increased lipolytic activity of sera from pre-eclamptic women due to the presence of a lysophospholipase.

Sera from pre-eclamptic women exhibit an increased lipolytic activity compared to sera of women with normal pregnancies. The null hypothesis of this study was that the increased release of free fatty acids (FFA) was due to hydrolysis of circulating triglycerides. The nature of the increased lipolytic activity was investigated by incubating sera from pre-eclamptic (PE) and normal pregnant women (C) with various lipid substrates radiolabeled in the FFA position. The release of FFA in PE-sera was not due to hydrolysis of triglycerides or diglycerides. Lysophosphatidylcholine, however, served as substrate for the enhanced lipolytic activity. By using lysophosphatidylcholine with radiolabeled FFA in the sn-1-position we found that 32 +/- 10 nmol FFA ml-1 h-1 was released in PE-sera, compared to 10 +/- 4 nmol FFA ml-1 h-1 in C-sera. This lysophospholipase activity appears independent of Ca2+ and other divalent cations. The increased release of FFA in sera of pre-eclamptic women can be explained by the presence of a lysophospholipase which releases the remaining fatty acid of lysophosphatidylcholine.

Antibodies↗

Lipids of frog retinal pigment epithelium: comparison with rod outer segments, retina, plasma and red blood cells.

The glycerolipid and fatty acid compositions of frog retinal pigment epithelium (RPE) were determined and compared with rod outer segments (ROS), retina, plasma, and red blood cells (RBC). The glycerolipid class composition of RPE was similar to RBC and ROS or retina, with phosphatidylcholine and phosphatidylethanolamine being the major components. The fatty acid composition of RPE differed substantially from that of plasma or RBC; the former contained much higher levels of C-20 and C-22 polyunsaturated fatty acids (PUFAs), such as 20:4n-6 and 22:6n-3, but less C-18 mono-, dienoic, and trienoic acids. The difference between RPE and ROS or retina with respect to fatty acid profile was also dramatic; RPE had relatively less 22:6n-3, but more 20:4n-6 and 18:2n-6, than ROS or retina. These results suggest that frog RPE cells may selectively take up C-20 and C-22 PUFAs from the circulation, but preferentially deliver 22:6n-3 to the ROS and retina. Fatty acid analyses show that 20:4n-6 and 22:6n-3 were unevenly distributed among RPE glycerolipids; phosphatidic acid, diglyceride, triglyceride, and phosphatidylserine are relatively more enriched in 22:6n-3 compared with 20:4n-6. This information might imply that these two PUFAs are metabolized differently inside the frog RPE cells.

Animals↗

Comparison of uptake and incorporation of docosahexaenoic and arachidonic acids by frog retinas.

Vertebrate retinas, especially photoreceptor cellular membranes, contain high levels of docosahexaenoic acid (DHA) and relatively low levels of arachidonic acid (AA). The present study was designed to test the hypothesis that DHA enrichment in the retina is the result of preferential uptake and incorporation relative to other fatty acids. Frog retinas were incubated in vitro with [3H]DHA or [3h]AA for up to 6 h, and the amounts of label in retinal lipids were quantitated. The incorporation of DHA into total lipids, triglycerides, phosphatidylcholine, and phosphatidylethanolamine was similar to that of AA when each was presented as the only substrate, and was linear with fatty acid concentration and incubation time. The addition of excess, unlabeled AA reduced the uptake and incorporation of DHA into retinal lipids. A slightly greater inhibition was noted for the uptake and incorporation of AA in the presence of unlabeled DHA. There was about 2-3 fold greater incorporation of DHA into phosphatidic acid, diglycerides, and phosphatidylinositol compared with AA, whereas the reverse was found for phosphatidylserine. The different levels of DHA and AA in retinal phospholipids cannot be explained by different rates of uptake and incorporation of these fatty acids into lipids, although some slight enrichment of DHA may be possible by this mechanism. The linear incorporation with fatty acid concentration suggests that the difference could be accomplished by controlling the amount and type of fatty acids delivered to the retina by the adjacent pigment epithelium.

Animals↗

Specificity and cross-reactivity of anti-galactocerebroside antibodies.

Anti-galactocerebroside (GalC) antibodies have been reported to inhibit myelin formation, cause demyelination, and block HIV-I infection of neural cells. We examined the binding of 3 monoclonal and polyclonal anti-GalC antibodies to a panel of purified glycolipids by ELISA and by an immunospot assay on nitrocellulose blots. All 3 antibodies bound strongly to GM1 ganglioside, monogalactosyl diglyceride, and asialo-GM1, and 2 of the antibodies bound to GD1b and psychosine. The anti-GalC antibodies also bound to 3 glycoprotein bands in human neuroblastoma cells on Western blot, and binding to the proteins was abolished by pre-treatment with pronase or with periodate which oxidizes the terminal carbohydrate residues. These results indicate that anti-GalC antibodies cross react with oligosaccharide determinants of other glycolipids and glycoproteins, and that these cross-reactivities may be responsible for some of the biological effects of the anti-GalC antibodies.

Animals↗

An experimental model of hypoxia on isolated rat heart in recirculating system: study of fatty acid metabolism with an iodinated fatty acid.

An experimental model of hypoxia was developed on isolated rat heart to study the effects of hypoxia on cardiac performance and metabolism. Fatty acid (FA) metabolism was explored by external detection with a labelled FA, iodohexadecenoic acid (IHA). Hearts, after 30 min preperfusion in an open system, were transferred in a recirculating system for 40 min and perfused with oleate, glucose, lactate, pyruvate and IHA, either in normoxia (pO2 = 660 mmHg) or in hypoxia (pO2 = 220 mmHg). After 40 min hypoxic recirculation, oxygen uptake and dynamic parameters, except the heart rate, decreased respectively by 56% and 44%, and remained constant throughout the perfusion. Glucose utilization increased 2 fold, endogenous glycogen fell by 50% and lactate + pyruvate production increased 3 fold, showing a stimulation of glycolysis. Oleate uptake decreased by 28%, while triglycerides content remained higher. The ATP/ADP ratio decreased by 24%. Conversely to oleate, IHA uptake was not significantly modified, but its intracellular fate showed a higher radioactivity in all lipid fractions: polar lipids, diglycerides, free FAs and triglycerides. beta oxidation of IHA, evidenced by iodide production, decreased by 39%. The external detection of cardiac radioactivity allowed us to obtain time-activity curves that were analyzed with a 4-compartment mathematical model. The data evidenced an esterification ratio significantly higher in hypoxia. The metabolism of IHA as estimated by the intracellular analysis or, in a non-invasive way, by external detection, was similar to the metabolism of oleate. Thus, lipid metabolism, in hypoxia, can be explored by external detection with IHA.

Animals↗

Blood and milk lipid responses induced by growth hormone administration in lactating cows.

Nine multiparous Holstein cows (average 5.8 yr, 63 to 132 days postpartum) were in a 28-day single reversal experiment in the Beltsville open circuit respiration chambers with two 14-day injection periods (placebo versus bovine growth hormone, 51.5 IU/day). With growth hormone treatment, milk fat percentage increased 25 to 29%, milk fat yield increased 41%, and cows averaged -13.7 Mcal/day energy balance. There were small increases of triglycerides and 1,2-diglycerides, core lipids, and small decreases of cholesterol and phospholipids, the membrane lipids. Fat from growth hormone treatment had 6% less short (6:0, 8:0, 10:0) and medium (12:0, 14:0, 14:1, 15:0, 16:0) chain fatty acids and 6% more long chain 18:1 fatty acids. Plasma of cows treated with growth hormone had an increase of concentrations of free fatty acids, but no shifts were apparent among other lipid classes. Analysis of total plasma fatty acids did not show any net changes, but within individual plasma lipid classes, 18:1 increased and 18:2 decreased. Overall changes of blood and milk lipids are consistent with the concept that adipose tissue reserves were mobilized in response to hormone treatment and that these mobilized lipids were the major carbon source for the 41% increase of milk fat secretion. Increases of de novo synthesis of short and medium chain fatty acids also occurred but much less. Cows treated with growth hormone were in negative energy balance, and the mechanism may differ when cows are in positive energy balance.

Animals↗

Regulation of in vitro metabolism of palmitate by carnitine and propionate in liver from dairy cows.

Regulation of in vitro palmitate metabolism by carnitine and propionate was investigated in liver obtained by biopsy from fasted nonlactating cows and from cows during early lactation. Liver slices from nonlactating cows during a 7-d fast esterified less palmitate than those from the same cows before fasting. Carnitine added in vitro increased hepatic oxidation and decreased esterification of palmitate in fed cows, but effects of carnitine were less during fasting. Propionate added in vitro decreased oxidation of palmitate; the effect was greater during fasting. In liver slices from cows during early lactation, carnitine increased oxidation and total utilization of palmitate and decreased palmitate esterification. Addition of tetradecylglycidic acid, an inhibitor of carnitine palmitoyltransferase I, prevented the carnitine-induced changes in palmitate metabolism. Substantial carnitine-independent oxidation of palmitate was observed in the presence of tetradecylglycidic acid. Tetradecylglycidic acid decreased esterification of palmitate to triglycerides but increased esterification to diglycerides. Effects of tetradecylglycidic acid and either propionate or pyruvate on palmitate oxidation were additive, indicating that propionate and pyruvate affect palmitate oxidation at sites other than carnitine palmitoyltransferase I. No interactions were detected between carnitine and propionate, but both compounds were potent regulators of palmitate metabolism in liver slices from cows during early lactation.

Animals↗

Fatty acid composition of glycerides and stereospecific analysis of triglyceride in pea seeds.

Pea seeds were shown to contain ten kinds of neutral lipids, among which triglyceride, free sterol and sterolester are the main components and diglyceride, monoglyceride, free fatty acid, wax and some pigments are the minor ones. The major component fatty acids in the glycerides and the free fatty acid are C18:2, C18:1 and C16:0. The positional distribution of fatty acids in triglyceride is such that, position 1 and 3, especially the former, abound in saturated fatty acids, and position 2 is filled almost entirely with unsaturated fatty acids.

Chemical Phenomena↗

Biochemical changes in rat liver after 18.5 days of spaceflight.

The effect of "weightlessness" on liver metabolism was examined using tissue from rats flown in earth orbit for 18.5 days aboard the Soviet Cosmos 936 biosatellite. Changes in the activities of certain carbohydrate and lipid enzymes were noted. Of the 28 hepatic enzyme activities assayed, two, palmitoyl-CoA desaturase and lactate dehydrogenase, increased, whereas five, glycogen phosphorylase, 6-phosphogluconate dehydrogenase, both acyltransferases which act on alpha-glycerolphosphate and diglycerides, and aconitate hydratase decreased. The remaining enzyme activities measured were unchanged. In addition, increased levels of liver glycogen and palmitoleate were noted which probably resulted from the lowered glycogen phosphorylase and increased palmitoyl-CoA desaturase activities, respectively, in those animals that experienced weightlessness. These changes caused by weightlessness were transient since all of the aforementioned alterations returned to normal values when measured in the livers of other rats which had flown in the biosatellite 25 days after recovery.

Aconitate Hydratase↗

[A study on the lipids of Chinese liverfluke, Clonorchis sinensis]

The present study was undertaken to observe the quality and quantity of lipids in the adult worms of Chinese liverfluke, Clonorchis sinensis. Lipid extraction was done by the methods of Folch et a1. (l957) and Kenny (1952), and then the extracted lipid fractions of the worm were separated by thin layer chromatography. Those fractions were also subjected to perform the quantitative analyses of glycerides, cholesterols and phospholipids. The results obtained were summarized as follows: 1. Total amount of glyceride was 37.56 mg per gram of worm tissue and the amount of monoglyceride was 8.34 mg per gm; diglyceride, 15.46 mg per gm; and triglyceride, 12.86 mg per gm. 2. Total amount of cholesterol was 3.30 mg per gm of worm tissue, and the esterified cholesterol (1.72 mg/gm) was a little more than that of free cholesterol (1.26 mg/gm). 3. The following 8 phospholipids were detected in the worm tissue of C. sinensis, i.e., lysophosphatidylcholine, phosphatidylcholine, phophatidylinositol, sphingomyelin, phosphatidylglycerol, phosphatidylserine, phosphatidylethanolamine and an unknown phospholipid.

Journal Article↗

Vascular metabolic dysfunction and lipotoxicity.

The purpose of this study was to determine the role of lipotoxicity in vascular smooth muscle (VSM). C(1)-BODIPY 500/510 C(12) used to assess the ability of VSM A7r5 cells to transport long-chain fatty acids showed that lipid transport did not appear to limit metabolism. Thin layer chromatography revealed that storage of transported fatty acid occurred primarily as mono- and diglycerides and fatty acids but not as triglycerides. We used lipid-induced apoptosis as a measure of lipotoxicity and found that 1.5 mM palmitate (6.8:1) bound to albumin resulted in a 15-fold increase in the number of apoptotic cells compared to the control at 24 hours. This apoptosis did not seem to be due to an increase in reactive oxygen species (ROS) since VSM cells incubated in palmitate showed less ROS production than cells incubated in albumin only. Similar exposure to oleate did not significantly increase the number of apoptotic cells compared to the control. Oleate actually significantly attenuated the apoptosis induced by palmitate, suggesting that unsaturated fatty acids have a protective effect on cells undergoing palmitate-induced apoptosis. These results suggest that vascular smooth muscle is vulnerable to lipotoxicity and that this lipotoxicity may play a role in the development of atherosclerosis.

Albumins↗

Pattern of skin surface lipids in some south-western Nigerians with acne vulgaris.

UNLABELLED: Unanswered questions still exist regarding pathophysiology of acne vulgaris generally and particularly in this environment. METHODS: Skin surface lipid (SSL) samples were collected by the heptane sponge technique from faces of 20 Nigerians with facial acne vulgaris and 25 controls. The subjects were classified into mild and moderately severe acne groups. Total cholesterol and triglycerides were determined and expressed in percentage (%) while Undetermined Skin Surface Lipids (USSL) (free fatty acids + squalene + wax ester + diglycerides) were computed. RESULTS: Triglycerides and total cholesterol levels were significantly higher in subjects with acne vulgaris compared with controls (p < 0.001 and p < 0.029 respectively). There was a progressively significant increase in triglycerides from control, though mild to moderately severe acne vulgaris subjects (P < 0.01) in all cases. In contrast there was a significant progressive decrease in USSL among the three groups (P < 0.001) in all cases. No significant difference was evident for all the values on comparison of female subjects with male subjects. There were however, significant increases in triglycerides and significant decreases in USSL levels for both male and female subjects with acne vulgaris compared with their respective controls (P < 0.02, P < 0.01, P < 0.03 and P < 0.014). CONCLUSION: Alterations in composition of SSL may in part be the pathophysiological basis of inflammatory acne vulgaris. Severity of the disorder appears to parallel triglyceride level but there was no association with sex. Triglycerides and total cholesterol levels are lower in SSL in this environment compared with hotter climates.

Acne Vulgaris↗

Stable bioavailability of cyclosporin A, regardless of food intake, from soft gelatin capsules containing a new self-nanoemulsifying formulation.

AIM: We recently succeeded in preparing soft gelatin capsules containing a new self-nanoemulsifying formulation consisting of cyclosporin A (CsA), triacetin, polyoxyl 40 hydrogenated castor oil, polysorbate 20, medium chain triglycerides and medium chain mono- and diglycerides. The soft capsules containing the new formulation exhibited a significantly improved physical stability in terms of the appearance of the gelatin capsule shells and the composition of the fill mass during long-term storage, compared to commercially available soft capsules containing CsA, in which ethanol was employed as a cosolvent of CsA. In the present study, the influence of a fat-rich meal on the bioavailability of CsA from the soft capsule containing the new formulation (test drug) was evaluated and the results compared to those obtained with a representative soft capsule of CsA. VOLUNTEERS AND METHODS: A randomized, open-label, 3-way crossover study was performed in the test capsules and reference soft capsules, in a fasted state or after a fat-rich breakfast. 18 healthy male volunteers received a single dose of the reference formulation (Neoral, Novartis AG, Basel, Switzerland) or test formulation (2 capsules each, 200 mg as CsA) with 240 ml of water with a 1-week washout period between the treatments, after a fat-rich (670 kcal, 45 g fat) breakfast (for the test drug, Treatment A; for the reference drug, Treatment B) or a 12-h fasting (for the test drug, Treatment C). Serial blood samples, collected over a 24-h period after the administration, were assayed for blood CsA concentrations using a specific monoclonal radioimmunoassay. RESULTS: The differences in bioavailability parameters (i.e., AUC(0-24h), AUC(0-infinity) and C(max)) between the treatments were within the range of 80-125% of the reference treatment. An analysis of variance (ANOVA) revealed no significant differences (p > 0.05) between subjects, formulations or periods. The 90% confidence intervals (CI) indicated that the differences between the treatments (Treatments A and B, Treatments A and C) were also within the criteria. CONCLUSION: These results indicate that the bioavailability of CsA from the test drug is equivalent to reference in the fed state, and is likely to be less influenced by a fat-rich meal. Therefore, the new formulation of CsA using triacetin appears to have an advantage over the commercial soft capsules of CsA using a volatile cosolvent such as ethanol.

Administration, Oral↗

Effects of an antitumor agent, ascofuranone, on the macromolecular syntheses of intact cells.

Ascofuranone (AF) has antitumor protective property on experimental tumors. We examined the action of AF on lymphoma L5178Y to explore the mechanism of the antitumor activity. AF completely prevented the growth of L5178Y at 25 micrograms/ml cytostatically. The compound exhibited general inhibitory effects on the macromolecular syntheses. Among them, protein synthesis was most severely inhibited by AF and to the same extent as by cycloheximide. AF, however, did not affect protein synthesis by cell-free system even at 2 mg/ml. Although AF inhibited the incorporation of [14C]acetate into total acid precipitable products only slightly, the synthetic pattern of simple lipids from [14C]acetate was significantly changed. Especially, the incorporation of [14C]acetate into squalene was almost completely blocked at 25 micrograms/ml. The incorporation of [14C]acetate into triglyceride was inhibited and that into cholesterol was enhanced. Concerning the diglycerides, the incorporation of [14C]acetate was enhanced and that of [3H]glycerol was inhibited. The incorporation of [3H]glycerol and [3H]mevalonate into the intact cell was significantly inhibited as compared with [14C]acetate. As those effects were not observed with cycloheximide, they were suggested to be characteristic of AF. AF inhibited hypotonic hemolysis. In contrast, hemolysis by deoxycholate was stimulated. Possible mechanism of the antitumor activity of AF is discussed.

Adult↗